Complete Review

Your Risks, Covered

A great opportunity to assess coverage.

There’s one guarantee in life and business. Things change. Our annual review is an opportunity to compare your existing coverage against your current needs to ensure your insurance remains appropriate to your situation.

Complete Annual Review

Step 1 of 9

11%

Client Information

Primary Contact Name*

FirstLast

What type(s) of insurance do you currently have with us?*

Personal Insurance

Business Insurance

Home Address*

Street AddressAddress Line 2CityStateZIP Code

Company Name*

Company Address*

Street AddressAddress Line 2CityStateZIP Code

Total Annual Sales*

Total Number of Employees*

Phone Number

Email Address*

Your Home(s)

Please think back over the last year when answering these questions.

Have you remodeled or made any major updates to an existing home(s)?*

Yes

No

(New roof, furnace, or electrical system)

Have you added a home security system?*

Yes

No

Have you started a home-based business?*

Yes

No

Have you purchased a secondary residence, including a condo or timeshare?*

Yes

No

Have you started participating as a service provider in the home sharing economy?*

Yes

No

(Airbnb, VRBO)

Please explain any changes to your home.

Your Automobiles and other “Vehicles”

Please think back over the last year when answering these questions.

Have you added an automobile, watercraft, or recreational vehicle?*

Yes

No

Have you added any new drivers?*

Yes

No

Have you added a vehicle provided by an employer?*

Yes

No

Have you had a child leave home to attend school or no longer considered a dependent?*

Yes

No

Have you started participating as a service provider in the ridesharing economy?*

Yes

No

(Uber, Lyft, Sidecar)

Please explain any changes to your automobiles and "other" vehicles.

Your Other Life Events

Please think back over the last year when answering these questions.

Have you added or changed ownership of any assets including titles, trusts or LLCs?*

Yes

No

Have you hired domestic help, nanny or housekeeper, either full or part-time?*

Yes

No

Have you purchased jewelry, art or other valuables that need to be added? Are there items that need to be changed or deleted?*

Yes

No

Have you had a significant change in net worth?*

Yes

No

Have you accepted a position on a board(s) of a profit or nonprofit organization(s)?*

Yes

No

Please explain any changes.

Your Business Structure

Please think back over the last year when answering these questions.

Have you changed the ownership structure of your business?*

Yes

No

Have you added new or changed your existing operations and/or products?*

Yes

No

Have you begun to buy supplies or sell your products overseas?*

Yes

No

Are you operating out of any new locations or have you closed locations?*

Yes

No

Please explain any changes to your business structure.

Your Personal Liability

Please think back over the last year when answering these questions.

Have you acquired, leased or sold a building, business property and/or equipment?*

Yes

No

Have there been any improvements and/or significant alterations to your building?*

Yes

No

Has your Inventory level changed significantly?*

Yes

No

Have you purchased, leased or sold any Vehicles?*

Yes

No

Please explain any changes to your personal liability.

Your Income Protection

Please think back over the last year when answering these questions.

Have your Businesses revenues changed by more than 10% since last year?*

Yes

No

Do you rely on a single supplier for more than 50% of your materials?*

Yes

No

Do you rely on a single buyer for more than 50% of your sales?*

Yes

No

Please explain any changes to your income protection.

Your Employees & Professional Liability Exposure

Please think back over the last year when answering these questions.

Do you have employees that regularly travel out of state or overseas for business?*

Yes

No

Do any employees use their own personal cars for business purposes?*

Yes

No

Do any Employees work outside your home state or work from their home regularly?*

Yes

No

Do you obtain Certificate of Insurance from all subcontractors, vendors and 1099 workers?*

Yes

No

Are any of the owners a member of any board of directors whether for profit or not?*

Additional Protection

McIntire & Associates is a full service agency providing solutions for personal, business, employee benefits and specialty Insurance needs for our clients.

Would you like to discuss any additional insurance protection with our firm?*

Yes

No

Confirmation

Your initials*

By completing this online form, you agree to having read the following disclaimer:

This information is not an offer to sell insurance. Insurance coverage cannot be bound or changed via submission of this online form/application, e-mail, voice mail, or facsimile. No binder, insurance policy, change, addition, and/or deletion to insurance coverage goes into effect until confirmed directly with a licensed agent. Note, any proposal of insurance we may present to you will be based upon the values developed and exposures to loss disclosed to us on this online form/application and/or in communications with us. All coverages are subject to the terms, conditions, and exclusions of the actual policy issued. Not all policies or coverages are available in every state. You also agree to release us from any liability if this information is accidentally viewed by unauthorized persons. We will only use this information for insurance quoting purposes and not to distribute to other parties.

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About McIntire & Associates

McIntire & Associates has been providing quality service and insurance coverage to the residents of Cleveland Tennessee and throughout Southeast Tennessee and North Georgia for over 30 years. Begun in 1981 by Bob McIntire and his father, Bill McIntire, the company has grown to one of the largest agencies in Bradley County.